Amendments for SB25-124
Senate Journal, March 19
After consideration on the merits, the Committee recommends that SB25-124 be amended
as follows, and as so amended, be referred to the Committee of the Whole with favorable
recommendation.
Amend printed bill, page 2, after line 8 insert:
"25.5-2.5-302. Legislative declaration. (1) THE GENERAL ASSEMBLY
FINDS THAT:
(a) NONPROFIT HOSPITALS COVERED UNDER THE 340B PROGRAM USE
340B PROFITS TO DECREASE OUT-OF-POCKET COSTS FOR LOW-INCOME PATIENTS;
(b) FEDERALLY QUALIFIED HEALTH CENTERS, RYAN WHITE CLINICS,
STATE AIDS DRUG ASSISTANCE PROGRAMS, AND CHILDREN'S HOSPITALS ARE
REQUIRED TO REPORT CERTAIN REVENUE AND USE DATA TO THE BENEFIT OF THE
COMMUNITIES THEY SERVE. NO SIMILARLY SITUATED REQUIREMENT EXISTS FOR
NONPROFIT HOSPITALS COVERED UNDER THE 340B PROGRAM.
(c) REQUIRING HOSPITALS COVERED UNDER THE 340B PROGRAM THAT
ARE LICENSED BY THE STATE TO REPORT INFORMATION RELATED TO THEIR
PARTICIPATION IN THE 340B PROGRAM TO THE STATE WOULD CREATE PARITY
IN THE USE OF 340B PROGRAM PROFITS.
(2) THEREFORE, THE GENERAL ASSEMBLY DECLARES THAT THE STATE
OF COLORADO HAS BOTH A SPECIFIED INTEREST IN AND PROPER RESPONSIBILITY
TO MONITOR NONPROFIT HOSPITALS COVERED UNDER THE 340B PROGRAM AND
ENSURE THEY ARE APPROPRIATELY SERVING THEIR COMMUNITIES AND THE
TAXPAYER INTERESTS OF THE STATE.".
Renumber succeeding C.R.S. sections accordingly.
Page 3, strike lines 1 through 5.
Renumber succeeding subsections accordingly.
Page 3, strike lines 11 through 13.
Renumber succeeding subsection accordingly.
Page 3, line 20, strike "OR DENVER HEALTH AND HOSPITALS." and substitute
"DENVER HEALTH AND HOSPITALS, A COMPREHENSIVE HEMOPHILIA DIAGNOSTIC
TREATMENT CENTER DESCRIBED IN 42 U.S.C. SEC. 256b (a)(4)(G), A
FEDERALLY-QUALIFIED HEALTH CENTER AS DEFINED IN 42 U.S.C. SEC. 1396d
(l)(2)(B), RYAN WHITE CLINICS, THE COLORADO STATE DRUG ASSISTANCE
PROGRAM, OR CHILDREN'S HOSPITALS IN COLORADO.".
Page 3, line 21, strike "(1) BEGINNING".
Page 3, strike lines 22 through 27.
Page 4, strike lines 1 through 17.
Page 4, line 18, strike "(3)" and substitute "(1)".
Page 5, line 22, after "PROFITS;" insert "AND".
Page 5, strike lines 26 and 27.
Page 6, strike lines 1 through 6.
Page 6, strike lines 8 through 11 and substitute "ITEMIZED COSTS RELATED TO
PROVIDING CHARITY CARE; AND".
Page 6, line 23, strike "AGGREGATE" and substitute "COLLECT".
Page 7, after line 4 insert:
"25.5-2.5-306. Access to 340B drugs. UNLESS THE RECEIPT OF 340B
DRUGS IS PROHIBITED BY THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN
SERVICES, A MANUFACTURER, WHOLESALER, THIRD-PARTY LOGISTICS PROVIDER,
OR REPACKAGER, OR AN AGENT, CONTRACTOR, OR AFFILIATE OF A
MANUFACTURER, WHOLESALER, THIRD-PARTY LOGISTICS PROVIDER, OR
REPACKAGER, INCLUDING AN ENTITY THAT COLLECTS OR PROCESSES HEALTH
INFORMATION, SHALL NOT, DIRECTLY OR INDIRECTLY, DENY, RESTRICT,
PROHIBIT, DISCRIMINATE AGAINST, OR OTHERWISE LIMIT THE ACQUISITION OF A
340B DRUG BY, OR DELIVERY OF A 340B DRUG TO, A HOSPITAL THAT IS EITHER
A SOLE COMMUNITY HOSPITAL DESCRIBED IN 42 U.S.C. SEC. 256b (a)(4)(O) OR
A CRITICAL ACCESS HOSPITAL DESCRIBED IN 42 U.S.C. SEC. 256b (a)(4)(N).".
Renumber succeeding C.R.S. sections accordingly.
Page 7, line 5, strike "Reporting." and substitute "Request of information.".
Page 7, lines 6 and 7, strike "THE STATE DEPARTMENT SHALL SUBMIT A REPORT
TO THE JOINT BUDGET COMMITTEE" and substitute "THE JOINT BUDGET
COMMITTEE SHALL ISSUE A REQUEST FOR INFORMATION TO THE STATE
DEPARTMENT REQUESTING INFORMATION".
Page 7, lines 12 and 13, strike "THE DEPARTMENT OF PERSONNEL AND
ADMINISTRATION SHALL SUBMIT A REPORT TO THE JOINT BUDGET COMMITTEE"
and substitute "THE JOINT BUDGET COMMITTEE SHALL ISSUE A REQUEST FOR
INFORMATION TO THE DEPARTMENT OF PERSONNEL AND ADMINISTRATION".
Health &
Human
Services
House Journal, May 3
5 SB25-124 be amended as follows, and as so amended, be referred to
6 the Committee of the Whole with favorable
7 recommendation:
8
9 Amend reengrossed bill, page 2, strike lines 9 through 24.
10
11 Page 3, strike lines 1 through 4.
12
13 Renumber succeeding C.R.S. sections accordingly.
14
15 Page 3, strike lines 7 through 15 and substitute:
16
17 (1) "340B DRUG" MEANS "MEANS A DRUG THAT:
18 (a) IS A COVERED OUTPATIENT DRUG WITHIN THE MEANING SET
19 FORTH IN 42 U.S.C. SEC. 256B;
20 (b) HAS BEEN SUBJECT TO ANY OFFER FOR REDUCED PRICES BY A
21 MANUFACTURER PURSUANT TO 42 U.S.C. SEC. 256b (a)(1); AND
22 (c) PURCHASED BY A 340B COVERED ENTITY, AS DEFINED IN 340B
23 (a)(4) OF THE FEDERAL "PUBLIC HEALTH SERVICE ACT", 42 U.S.C. SEC.
24 256b (a)(4). AS USED IN THIS SUBSECTION (2)(c), A DRUG IS CONSIDERED
25 "PURCHASED" IF IT WOULD HAVE BEEN PURCHASED BUT FOR THE
26 RESTRICTION OR LIMITATION DESCRIBED IN SECTION 6-29-105.
27 (2) "340B NET REVENUE" MEANS THE DIFFERENCE BETWEEN THE
28 AGGREGATED MARKET RATE COSTS AND THE AGGREGATED ACQUISITION
29 COSTS FOR 340B DRUGS.".
30
31 Page 4, line 7, before "DENVER" insert "AN INDEPENDENT NONPROFIT
32 HOSPITAL WITH FEWER THAN FIFTY LICENSED BEDS,".
33
34 Page 4, line 13, strike "profits." and substitute "net revenue.".
35
36 Page 4, line 14, strike "PROFITS" and substitute "NET REVENUE".
37
38 Page 4, strike line 16.
39
40 Page 4, line 17, strike "COMPENSATION" and substitute
41 "(a) COMPENSATION".
42
43 Page 5, line 2, strike the second "AND".
44
45 Page 5, line 3, strike "EXPENSES." and substitute "EXPENSES; AND".
46
47 Page 5, after line 3, insert:
48
49 "(g) SALARIES FOR THE NONPROFIT HOSPITAL'S CHIEF EXECUTIVE
50 OFFICER, CHIEF FINANCIAL OFFICER, CHIEF ADMINISTRATIVE OFFICER,
51 CHIEF OPERATIONS OFFICER, OR ANY OTHER SENIOR EXECUTIVE OFFICER
52 AT THE VICE PRESIDENT LEVEL OR ABOVE.
53
1 (2) (a) A NONPROFIT HOSPITAL THAT IS A REPORTING HOSPITAL, AS
2 DEFINED IN SECTION 25.5-1-701, MUST SPEND AT LEAST EIGHTY PERCENT
3 OF 340B NET REVENUE ON DIRECT PATIENT SERVICES OR CAPITAL
4 IMPROVEMENTS THAT MAINTAIN OR INCREASE ACCESS TO PATIENT CARE
5 FOR LOW-INCOME POPULATIONS.
6 (b) FOR PURPOSES OF SUBSECTION (2)(a) OF THIS SECTION, DIRECT
7 PATIENT SERVICES INCLUDES:
8 (I) CHARITY CARE;
9 (II) THE DIFFERENCE BETWEEN MEDICARE AND MEDICAID
10 PAYMENTS AND THE COST OF CARE;
11 (III) FINANCIAL SUPPORT PROVIDED TO A FEDERALLY QUALIFIED
12 HEALTH CENTER, A CRITICAL ACCESS HOSPITAL AS DESCRIBED IN 42 U.S.C
13 SEC. 256b (a)(4)(N), OR OTHER 340B COVERED ENTITY, AS DEFINED IN
14 340B (a)(4) OF THE FEDERAL "PUBLIC HEALTH SERVICE ACT", 42 U.S.C.
15 SEC. 256b (a)(4). THAT IS NOT A HOSPITAL, FOR THE PURPOSE OF
16 INCREASING ACCESS TO CARE FOR LOW-INCOME PATIENTS; AND
17 (IV) OTHER HEALTH-CARE PRODUCTS AND SERVICES PROVIDED
18 FOR LOW-INCOME PATIENTS THAT ARE OTHERWISE NOT REIMBURSED OR
19 REIMBURSED AT BELOW COST.".
20
21 Page 5, strike lines 4 through 27.
22
23 Page 6, strike lines 1 through 17 and substitute:
24
25 "25.5-2.5-304. Hospital transparency reporting. (1) A
26 NONPROFIT HOSPITAL THAT IS A REPORTING HOSPITAL, AS DEFINED IN
27 SECTION 25.5-1-701, SHALL INCLUDE THE FOLLOWING INFORMATION IN
28 THE ANNUAL REPORT SUBMITTED PURSUANT TO SECTION 25.5-1-703(3):
29 (a) THE AGGREGATE ACQUISITION PRICE FOR PRESCRIPTION DRUGS
30 OBTAINED UNDER THE 340B PROGRAM;
31 (b) THE AGGREGATED MARKET PRICE FOR DRUGS OBTAINED UNDER
32 THE 340B PROGRAM AND DISPENSED OR ADMINISTERED TO PATIENTS;
33 (c) THE NUMBER OF TRANSACTIONS FOR PRESCRIPTION DRUGS
34 DESCRIBED IN SUBSECTION (1)(b) OF THIS SECTION;
35 (d) THE SUM OF THE AGGREGATED PAYMENTS MADE TO:
36 (I) A CONTRACT PHARMACY TO DISPENSE DRUGS OBTAINED UNDER
37 THE 340B PROGRAM;
38 (II) ANY OTHER ENTITY, THAT IS NOT A 340B COVERED ENTITY AS
39 DEFINED 340B (a)(4) OF THE FEDERAL "PUBLIC HEALTH SERVICES ACT",
40 42 U.S.C. SEC. 256b (a)(4) OR A CONTRACT PHARMACY, FOR MANAGING
41 ANY ASPECT OF THE COVERED ENTITY'S 340B PROGRAM.".
42
43 Page 6, line 20, strike "WHOLESALER,".
44
45 Page 6, line 22, strike "WHOLESALER,".
46
47 Page 6, strike line 27.
48
49 Page 7, strike lines 1 and 2 and substitute "A 340B COVERED ENTITY, AS
50 DEFINED IN 42 U.S.C. SEC. 256b (a)(4)."
51
52 Page 7, strike lines 18 through 27.
53
54 Page 8, strike lines 1 through 16.
1 Renumber succeeding section accordingly.
2
3
House Journal, May 5
52 Amendment No. 1, Health & Human Services Report, dated May 3, 2025,
53 and placed in member’s bill file; Report also printed in House Journal,
54 May 3, 2025.
55
1 Amendment No. 2, by Representative Brown:
2
3 Amend the Health and Human Services Committee Report, dated May 3,
4 2025, page 1, strike lines 12 through 14 and substitute "256b (a)(4).".
5
6 Amendment No. 3, by Representative Brown:
7
8 Amend the Health and Human Services Committee Report, dated May 3,
9 2025, page 3, line 19, strike "(a)(4)."" and substitute "(a)(4); A PHARMACY
10 CONTRACTED WITH 340B COVERED ENTITY, AS DEFINED IN 340B (a)(4) OF
11 THE FEDERAL "PUBLIC HEALTH SERVICES ACT", 42 U.S.C. SEC. 256b
12 (a)(4); OR A LOCATION OTHERWISE AUTHORIZED BY A 340B COVERED
13 ENTITY, AS DEFINED IN 340B (a)(4) OF THE FEDERAL "PUBLIC HEALTH
14 SERVICES ACT", 42 U.S.C. SEC. 256b (a)(4) TO RECEIVE AND DISPENSE A
15 340B DRUG.".".
16
17 As amended, ordered revised and placed on the Calendar for Third
18 Reading and Final Passage.
19